Chapter 11 - Schizophrenia
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| Schizophrenia | Disorder marked by breakdown in cognitive, emotional and behavioral functions. A rare but devestating illness.
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| What are delusions? | Extremely irrational beliefs remain despite lack of supporting evidence.
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| Most common types of delusions | Delusion of persecution, reference, being controlled, grandeur, thought broadcasting and thought insertion.
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| Thought Disorder | Breakdown in processing of thoughts which leads to distorted speech. Distorted speech is however not unique for Schizophrenia.
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| Tangential speech | When a person goes on a tangin before getting to the point
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| Loose associations | When a person goes on a tangin without reaching a point.
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| Poverty of Speech | Very vague speech, usually slow and convey very little info.
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| Thought Blocking | When a person starts talking then suddenly stops.
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| Neologisms | Made up words
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| Perseveration | Repeating things.
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| Clanging | Saying a string of words that all rhyme.
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| Hallucinations | Perception that occurs in the absence of external stimuli.
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| What is the most common hallucination? | Auditory
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| Variations in auditory hallucinations | 3rd person commentary and command hallucinations.
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| Anhedonia | Inability to experience pleasure. No change in mood.
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| Flat Affect | Behavior that doesn't express any change in mood. Voice and expressions usually just stayes flat.
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| Inappropriate Affect | Example: Laughing at a funeral.
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| Avolition | Inability to persist in goal-directed behavior.
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| Catatonia | Posturing or mannerisms. Example, freezing in a posture for an hour.
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| Negativistic Catatonia | Staying at a posture and being very stiff, almost impossible to move.
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| Waxy flexibility Catatonia | Staying at a postire and being very flexible and moveable.
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| Echolalia | Repeating what people say to you
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| Echopraxia | Repeating, immitating motormovements.
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| Positive symptoms | Added behavior that wasn't present in the person's life before Schizophrenia.
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| Negative symptoms | Missing behavior that was present before in a person before Schizophrenia Example: flat affect.
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| Psychosis versus Schizophrenia | Psychosis: Problems with knowing what is reality and what is not. Schizophrenia: a psychotic disorder because it makes people have difficulties with knowing what's reality and what's not.
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| Diagnosis of Schizophrenia | 1.Two or more over a month: Delusions, hallucinations, disordered speech, disorganized or catatonic behavior, negative symptoms. 2.Marked impairment in fuctioning 3.Signs of disorder for 6 months 4.symptoms not due to drugs or medical conditions.
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| Paranoid Type | 1.one or more delusions or frequent auditory hallicinatiosn 2.delusional tend to be around a theme. Example: persecution, grandeur, jealousy.
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| Disorganized Type | Disorganized speech, disorganized behavior, flator inappropriate affect. Delusions tend to be disorganized (religious or sexual. Often neglect hygiene.
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| Catatonic Type | Impaired motor behavior. Periods of stupor or catalepsy. Behavioral negativism. Posturing or mannerisms. Echolalia or echopraxia. Excessive, purposeless behavior.
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| Undifferentiated type | Major symptoms of schizophrenia but doesn't fit in one preticular type. Might fit on none or in many.
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| Residual Type | Person who used to have schizophrenia and recovered but still have symptoms but not enough for full schizophrenic diagnosis.
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| Brief psychotic disorder | One of more positive symptoms of schizophrenia that lasts less than a month and is caused by trauma orextreme stress.
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| Folie a deux (Shared psychotic disorder) | Delusions due to living with someone else with delusions. Little is known about this condition.
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| Genetic factors for Schizophrenia | Family studies and twin studies where made to determine the cause of Schizophrenia and it whowed that there is a genetic factor to the illness. The more genes you share with a person with schizophrenia, the bigger the risk is that you get it.
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| Prevelenace of Schizophrenia amongst the general population | 3%
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| The prevelance of Schizophrnia. Monozygotic twins versus fraternal twins. | If a monozygotic twin has schizophrenia, there is a 48% that the other one will get it. If a fraternal twin has schizophrenia there is only a 17% chance that the other one will get it.
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| Environmental factors | There are proof that says that the environment can play an important factor to the cause of Schizophrenia. Ex: Not both of monozygotic twins have to get it. Spouses of person with schizophrenia can get it, as well as half siblings.
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| Studies of the Offsrping of twins | Cildren fall in 1 of 4 groups. 4 groups: either the twins are 1.identical or 2.fraternal, either 3.parent had schizophrenia or 4.twin of parent had schizophrenia.
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| Result of studies of the offspring of twins | Three groups were the same: mom has schizophrenia but moms identical twin doesnt, mom doesn't but moms identical twin does, mom has but moms fraternal doesnt. The only one that was radically less was: moms fraternal twin does but mo doesn't.
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| Search for behavioral markers of schizophrenia | Smooth-pursuit eye movement. Tracking an object with head still: eyes move jerky. And many of their relatives!
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| Dopamine Hypothesis | Antipsychotic drug. Drugs found to reduce posative symptoms, they blockes action of neurostransmitters. Conclusion: schizophrenia related to too much dopamine activity. Proof: drugs that increase dopamine cab produce schizophrenic symptoms.
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| Biochemical factors: Brain absnormalities | 3 of 4 adults with schizophrenia show loss of brain tissue. Evidence: enlarged ventricles and reduced brain tissue volume.
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| Hypofrontality in Pre-frontal cortex | Prefrontal cortex handles planning, expresses emotions and appropriate social functioning and organizes though processes. Hypofrontality decreases brain activity in pre-frontal cortex. This occurs with schizophrenia: could explain negative sympotms.
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| Schizophrenia caused by flu? | Severe flu during 2nd trimester can results in a higher risk of schizophrenia for child.
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| Stress causes Schizophrenia | Stress may activate underlying vulerability and or increase risk of relapse.
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| Family interactions: Expressed emotions | Low tolerance and empathy for the ill family member can result in relapse. Living in a hostile and critical household increase relapse. Ex: patient with EE 50% and patient without EE 14%
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| Diathesis-Stress model | Diathesis is the predisposition to develop schizophrenia, most often biological. Stess combined with the diathesis can lead to schizophenia
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| Historical medical treatments | Lobotomy, electroconvulsive therapy, insulin shock therapy (induse seizures and then coma, when the patient wakes up he is supposebly treated.)
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| Antipsychotic medication | Ex. Haldol, Thorazine, Stelazine. They block dopamine receptors in the brain. They primarily help positive symptoms.
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| Short term Side effects of antipsychotic medication | Extrapyramidal side effects (parkinson-like) such as stiff muscles and spasms
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| Long term die effects of antipsychotic medication | 1 in 4 develop Tardive Dyskinsesia (TD). Involuntary movements (face, mouth, neck, arms, legs)
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| Individual and group psychotherapy | Focus on stress reduction, social skills, dealing with criticism, and medication compliance
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